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Neurology

Neuro

NeuropathyClinical PresentationNerve supplyMechanisms of InjuryTreatment (specific tx)
Claw Hand ulnar nerve injury; 4th 5th digits of hand remain partially extended when attempting to make a fist; SYMPTOMS- muscle wasting at hypothenar & inteross. spaces; altered sensation, anhidrosis (diminished/absent sweating), vasomotor changes ulnar nerve (medial cord C8 & T1 ventral rami) supplies FLEXOR CARPI ULNARIS, MOST SMALL HAND MUSCLES & SKIN OVER MEDIAL HAND & FINGERS) fracture of med. epicondyle, mid-forearm or Colle's; elbow dislocation; post-sx complication; leprosy; compression from handcuffs, motorcycling; repetitive strain; contusion or laceration at wrist or hand towel roll on palmar side to support hand/digits; tx C/spine -> unaffected arm -> affected arm; PROM (flex. & adduct. of MCP, extens. 4th & 5th IPs); AFROM (later stage 75% regeneration, have them push objects away using 4th & 5th digits)
Dorsal Scapular Nerve injury affected scapula located further down midline than unaffected side; SYMPTOMS- paralysis of rhomboids dorsal scapular nerve (C4 & C5 ventral rami) supplies RHOMBOIDS & part of LEVATOR SCAPULAE (blank) (blank)
Sciatic Nerve injury (aka Piriformis Syndrome) pain in low back or hip radiating down posterior thigh and into leg; largest & broadest, sciatic nerve (L4-S3 ventral rami) supplies muscles of posterior thigh, skin & muscles of leg & foot) compression of piriformis muscle; herniation of lumbar IV disc which compresses & compromises either L5 & S1 nerve root focus on glutes, greater trochanter (spoking); TP -> piriformis, glute max, min & med), hold/relax -> seg. stretch to glute med. then heat; jt play (anter. glide to hip/sacrum; friction anywhere along piriformis followed by ice. End with thorough flush
Winged Scapula injury to long thoracic nerve; scapula prominent when patient presses hands against wall; medial border moves lateral & posterior; arm unable to abduct above horizontal position long thoracic nerve (C5, C6, C7 ventral rami) supplies serratus anterior (blank) (blank)
Musculocutaneous Nerve injury weakened elbow flexion; SYMPTOMS- paralysis of coracobrachialis, biceps & brachialis; loss of sensation on lateral surface of forearm musculocutaneous nerve (C5, C6, C7 spinal nerves) supplies all mm in anterior compart. - coracobrachialis, biceps & brachialis. Terminal branch -> lateral antebrachial cutaneous nerve which supplies lateral side of forearm uncommon but may be inflicted by weapon (blank)
Obturator Nerve Injury painful spasms of adductor mm of thigh; sensory deficits in medial thigh region obturator nerve (L2, L3, L4) supplies ADDUCTOR muscles of thigh pelvic surgery (blank)
Saphenous Nerve Injury pain radiates along medial border of foot saphenous nerve arise from femoral nerve (L2, L3, L4 ventral rami) & it's the terminal cutaneous branch, which supplies skin & fascia of anteromedial aspect of KNEE, LEG & FOOT (blank) (blank)
Hand of Benedicton median nerve injury; 2nd & 3rd digits of hand remain partially extended when attempting to make a fist; flaccidity in opponens pollicis thus unable to oppose esp. medial rotation; atrophy of forearm flexors & thenar mm; causalgia (burning sensation) median nerve (C6,C7 spinal nerves is lateral cord + C8,T1 spinal nerve is medial cord) supplies skin over lateral hand bisecting 4th digit, FLEXORS of forearm EXCEPT FLEX. CARPI ULNARIS & ulnar 1/2 of FDP perforating wound in elbow region -> fracture or dislocation @ elbow, wrist or carpal bones (lunate & scaphoid). Compression-> fibrosis & hypertonicity: CTS/Pronator Teres synd.. Trauma-> traction, contusion, laceration at wrist & hand elevate limb above heart. MLD. Towel roll <-> first 2 digits to increase adduction
Thoracodorsal Nerve Injury inability to pull themselves up using arms; SYMPTOMS-> paralysis of latissiumus dorsi thoracodorsal nerve (C6,C7,C8 spinal nerves) supplies latissimus dorsi vulnerable during sx of inferior axilla (blank)
Axillary Nerve Injury absence of rounded contour of shoulder (flattened appearance). SYMPTOMS-> atrophy of deltoids & loss of sensation on lateral side of prox. arm Axillary nerve (C5,C6 spinal nerves) supplies TERES MAJ., DELTOID & SHOULDER JT damage during dislocation of shoulder or fracture of prox. humerus (blank)
Drop Foot injury to common peroneal nerve; foot & toes drag on floor when walking; loss of ankle dorsiflex.& foot eversion. SYMPTOMS-> paralysis of all mm in anterior & lateral leg, loss of sensation on anterolat. leg & dorsum of foot; steppage gait for clearance common fib. nerve is LATERAL branch of sciatic nerve @ 1/2 way down thigh (L4-S3). It supplies extensor & abductor mm, knee jt & skin of distal 3rd of anterior leg, dorsum of foot & all digits most commonly injured due to its superficial position (blank)
Wrist Drop radial nerve injury; inability to extend wrist & digits @ MCP jts. Minimal sensory loss. SYMPTOMS -> elbow flexed, hand pronated, thumb adducted Radial nerve (C5-T1) arise from posterior cord of brachial plexus. It supplies all extensor mm of upper limb-> triceps, anconeous, all extensors fracture on humeral body & is at superficial cutaneous branch of radial nerve towel roll under wrist & in elbow crease. Treat C/spine -> unaffected arm -> affected arm. PROM in early stage for wrist extension, fingers & thumb. AFROM in later stage (75% regeneration) of piano playing exercise
Superior Gluteal Nerve Injury gluteus medius limp (Trendelenburg gait). Weakened thigh abduction, severely impaired medial thigh rotation Superior gluteal nerve (L4,L5,S1) supplies glute med, glute min & tensor fascia lata (blank) (blank)
Tibial Nerve Injury inability to plantarflex ankle &/or flex toes. SYMPTOMS-> paralysis of flexor mm, intrinsic mm of sole of foot & loss of sensation on sole of foot Tibial nerve (L4-S3) is medial terminal branch of sciatic nerve. It supplies posterior muscles of leg & knee jt & skin of lateral side of leg & ankle uncommon but can be injured by deep lacerations or wounds (blank)
Tarsal Tunnel Syndrome entrapment of tibial nerve in ankle. re: tibial nerve injury caused by edema & tightness in ankle involving synovial sheaths of tendons of mm in posterior leg compartment. (blank)
Entrapment of Superficial Branch of Fibular Nerve SYMPTOMS-> pain along lateral side of leg & dorsum of ankle & foot; possible numbness & paresthesia w/ increased activity. Paralysis of all mm in anterior & lateral leg (nerve severed); loss of sensation on anterolat. leg & dorsum of foot Superficial fibular nerve supplies FIBULARIS LONGUS & BREVIS, DISTAL 3RD OF ANTERIOR LEG, DORSUM OF FOOT & ALL DIGITS EXCEPT LATERAL SIDE OF 5TH & 1ST INTERDIGITAL CLEFT recurrent stretching of nerve - chronic ankle sprains (blank)
Pronator Teres Syndrome entrapment of median nerve @ elbow. SYMPTOMS-> Pain & tenderness in prox. aspect of anterior arm median nerve (C6-T1) supplies skin over lateral hand bisecting 4th digit & forearm flexors EXCEPT Flexor Carpi Ulnaris entrapment of median nerve (blank)
Cubital Tunnel Syndrome entrapment of ulnar nerve re: claw hand ulnar nerve compression in cubital tunnel. Tendinous arch joining humeral/ulnar heads of attachments of Flexor Carpi Ulnaris (blank)
Carpal Tunnel Syndrome entrapment of median nerve. SYMPTOMS-> paresthesia, hypoesthesia, anesthesia in lateral 3 & 1/2 digits; progressive loss of coordination & strength in thumb; eventually radiates into forearm & axilla re: pronator teres syndrome lesion reduces size of carpal tunnel (blank)
Guyan's Canal Syndrome entrapment of ulnar nerve AT WRIST re: ulnar nerve compression of ulnar nerve (blank)
Created by: LInda_J
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